Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 24144 | TX |
NPI | 1083870281 |
---|---|
Provider Name | Dr. Dimitrios Elias Kontogiorgos |
First Address | Dallas, TX 75206-2611 |
Second Address | Dallas, TX 75206-2611 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2008 |
Last Update Date | 06/08/2008 |